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Introduction: Cellulitis is a common infection, especially among the elderly, and compression therapy is often recommended to reduce acute oedema and pain. A previous study showed that compression therapy led to a lower incidence of recurrent cellulitis in lower extremities in patients with chronic oedema. The aim of this study was to describe clinical characteristics of patients with cellulitis., Methods: This was a retrospective descriptive study reviewing medical records and medicine registrations in patients ≥ 18 years with cellulitis., Results: A total of 104 patients were hospitalised with cellulitis; 13 were excluded. The median age was 75 years (range: 33-103 years), 64% > 70 years. The median admission time was five days (range: 1-24 days). Median antibiotic treatment duration was 11 days (range: 4-56 days). A total of 45% were current or former smokers, 40% were overweight, 48% had preexisting chronic oedema of the affected area, 90% had become infected in the lower extremities and 19% were readmitted within six months. A total of 51% had a new antibiotic treatment prescribed after being discharged, and 66% received compression therapy., Conclusions: Cellulitis frequently affects older patients, especially smokers, people with overweight and chronic lymphoedema. In all, 66% were treated with compression therapy that did not have a clear effect on their readmission rate, probably because the patients receiving compression therapy had a more severe infection complicated by severe oedema and a higher risk of reinfection. An increased focus on the use of compression therapy in conjunction with health preventive interventions may have a positive impact on the relapse rate., Funding: None., Trial Registration: Not relevant., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Introduction: Osteoporosis and osteoporotic fractures typically affect postmenopausal women, and osteoporotic fractures significantly increase disability, morbidity and mortality. Several anti-osteoporotic agents are available and have been shown to effectively reduce the incidence of low-energy osteoporotic fractures. However, the post-osteoporotic fracture treatment rate remains low. The purpose of the present study was to follow up on patients with a recent hip fracture with primary focus on anti-osteoporotic treatment and dual-energy X-ray absorptiometry (DXA)., Methods: We included patients ≥ 65 years of age admitted to a department of orthopaedic surgery in Denmark from 1 June 2019 to 30 May 2020., Results: In this period, 570 patients ≥ 65 years were treated for a hip fracture. A total of 16.7% of the patients received anti-osteoporotic treatment at follow-up and 6.5% initiated anti-osteoporotic treatment or had a relevant change in anti-osteoporotic treatment. Only 9.8% had a DXA after their fracture; and among this group, 48% received anti-osteoporotic treatment., Conclusion: The majority of patients with a recent low-energy hip fracture did not receive a DXA, did not have a relevant follow-up or received any anti-osteoporotic treatment. The problem is global and needs to be addressed. Starting treatment with anti-osteoporotic medicine before discharge from the orthopaedic department and referring the patient to a DXA at the same time may be part of the solution., Funding: none., Trail Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Introduction: Utility of dipstick analysis must be investigated in patients admitted to the emergency department. The aim of this study was to evaluate if urine dipstick analysis can be used to detect significant bacteriuria. The cross-sectional study was performed in the Emergency Department of Copenhagen University Hospital - Herlev Hospital, Denmark., Methods: We recorded urine dipstick analysis of 500 adult patients admitted to the Emergency Department. Dipstick results were compared with urinary culture., Results: Sensitivity for leukocyte esterase (LE) was 80.9%, but specificity was 58%. The sensitivity of nitrite was 46.5%, and specificity was 90%. The positive predictive value (PPV) and negative predictive value (NPV) of LE for women were 54.5% and 75.9%; for men, 50.0% and 91.6%. PPV and NPV for nitrite in women were 85.9% and 66.8%; for men, 62.9% and 88.7%. Positive LE and positive nitrite had a PPV of 90.2% for women and 70.4% for men. Negative LE and negative nitrite had an NPV of 80.9% for women and 93.3% for men., Conclusions: No single parameter or combination of parameters on the urine dipstick analysis can be used reliably to predict positive urine culture in women. The most accurate predictor of negative urine culture in men is the combination of negative nitrites and negative LE. To minimize unnecessary use of antibiotics, treatment can be delayed in female patients with positive urine dipstick until urine culture results are available., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)